This study explores the complex interplay between socio-cultural factors and the effectiveness of malaria prevention strategies, with a focus on the utilization of Insecticide-Treated Nets (ITNs) among women in rural Sierra Leone. By employing a sociological lens that incorporates feminist, functionalist, and conflict theories, the research highlights how livelihood activities, socio-cultural norms, beliefs, and gender dynamics influence susceptibility to malaria and the adoption of preventive measures. The study emphasizes the critical need for integrating socio-cultural and biomedical models to enhance the effectiveness of malaria interventions. Through a detailed examination of the lived experiences of women in rural communities, this research provides insights into the socio-cultural barriers and facilitators to ITN utilization. It argues for a holistic approach to malaria prevention that recognizes the significance of socio-cultural contexts, gender-specific vulnerabilities, and the empowerment of women in the fight against malaria. The findings underscore the importance of community-engaged strategies and the inclusion of women's perspectives in developing targeted malaria control programs that bridge the gap between biomedical solutions and socio-cultural realities.